Augmented Reality in Real-Time Telemedicine and Telementoring: Scoping Review (Preprint)

BACKGROUND In the last decade, mixed reality technologies including augmented reality (AR) have emerged in healthcare as tools for data visualization and simulation learning. AR technology, which has largely been explored for communication and collaboration in non-health contexts, could play a role in shaping future remote medical services and training. This review summarizes existing articles implementing AR in real-time (“synchronous”) telemedicine and telementoring to create a foundation for healthcare providers and developers to understand future opportunities in remote care and education. OBJECTIVE This review describes the AR devices and platforms used in real-time telemedicine and telementoring, the tasks for which AR has been implemented, and the ways these implementations were evaluated in order to identify gaps in research that provide opportunity for further study. METHODS We searched PubMed, Scopus, Embase, and MEDLINE to identify English-language articles from January 1, 2012, through February 13, 2022 involving AR technology in a real-time interaction related to telemedicine or telementoring. The search terms were “augmented reality” OR “AR” AND “remote” OR “telemedicine” OR “telehealth” OR “telementoring.” Conference abstracts, systematic reviews, meta-analyses, and perspective-based studies were excluded. Articles that met criteria and related to healthcare were included for analysis. RESULTS 31 articles met inclusion criteria and were categorized within themes of patient evaluation, medical intervention, and education. 16 AR devices and platforms were identified, with the most common features being the ability for remote users to annotate and virtually display their hands or tools in the local user’s view. Most studies focus on consultation and procedural education, with surgery, emergency, and hospital medicine being the most represented specialties. End variables were most often measured with feedback surveys and interviews. The most common objective measures were time to task completion and performance. Long-term outcome and resource cost measurements were rare. Across the studies, user feedback was consistently positive for perceived efficacy, feasibility, and acceptability. Comparative trials demonstrate that AR-assisted conditions have noninferior reliability and performance and do not consistently extend procedure times compared to in-person controls. CONCLUSIONS Studies implementing AR in telemedicine and telementoring have demonstrated the technology’s ability to enhance access to information and facilitate guidance in multiple healthcare settings. However, AR’s role as an alternative to current telecommunication platforms or even in-person interactions remains to be validated, with many disciplines and provider-to-non-provider uses still lacking robust investigation. Additional longitudinal and randomized controlled studies with comparisons to existing methods would offer the most insight to this intersection, but a lack of standardized tools and adoption may hinder the creation of larger cohort studies. Overall, AR has the potential to complement and advance the capabilities of remote medical care and learning, creating a unique opportunity of involvement for innovators, providers, and patients.